Editorial
Metabolic dysfunction-associated steatohepatitis (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) require urgent attention by primary care physicians and endocrinologists
La esteatohepatitis asociada a disfunción metabólica (MASLD) y la esteatohepatitis asociada a disfunción metabólica (MASH) requieren atención urgente por parte de médicos de atención primaria y endocrinólogos
Didac Mauricioa,b,
, Javier Escaladac,d, Antonio Péreza,e, Manuel Romero-Gómezf, Kenneth Cusig, Zobair M. Younoussih,i, Jeffrey V. Lazarusi,j,k,l
Corresponding author
a Department of Endocrinology & Nutrition, CIBERDEM – IR Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
b Faculty of Medicine, University of Vic & Central University of Catalonia, Vic, Spain
c Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
d Fundación de la Sociedad Española de Endocrinología y Nutrición, Madrid, Spain
e Sociedad Española de Diabetes, Madrid, Spain
f Digestive Diseases Department & CIBEREHD, Virgen del Rocío University Hospital, Institute of Biomedicine of Seville (HUVR/CSIC/US), University of Seville, Seville, Spain
g Division of Endocrinology, Diabetes & Metabolism, University of Florida, Gainesville, USA
h Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, Virginia, USA
i The Global NASH Council, Washington, DC, USA
j Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
k Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
l CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA
Ver másRead
150
Timeswas read the article
51
Total PDF
99
Total HTML
Share statistics
array:22 [ "pii" => "S2530016424000259" "issn" => "25300164" "doi" => "10.1016/j.endinu.2024.01.006" "estado" => "S300" "fechaPublicacion" => "2024-04-01" "aid" => "1464" "copyright" => "SEEN y SED" "copyrightAnyo" => "2024" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Endocrinol Diabetes Nutr. 2024;71:149-51" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S2530016424000405" "issn" => "25300164" "doi" => "10.1016/j.endinu.2024.01.008" "estado" => "S300" "fechaPublicacion" => "2024-04-01" "aid" => "1466" "copyright" => "SEEN y SED" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Endocrinol Diabetes Nutr. 2024;71:152-62" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Correlation of dietary inflammation index and dietary pattern with mild cognitive impairment in patients with type 2 diabetes" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "152" "paginaFinal" => "162" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Correlación entre el índice inflamatorio alimenticio y el patrón alimenticio con el deterioro cognitivo leve en pacientes con diabetes mellitus tipo 2" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3319 "Ancho" => 2500 "Tamanyo" => 316198 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Flow chart showing the patients included in the study.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Shengdan Pu, Yuxin Xu, Xuewei Tong, Yitong Zhang, Xiaotong Sun, Xinyuan Gao" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Shengdan" "apellidos" => "Pu" ] 1 => array:2 [ "nombre" => "Yuxin" "apellidos" => "Xu" ] 2 => array:2 [ "nombre" => "Xuewei" "apellidos" => "Tong" ] 3 => array:2 [ "nombre" => "Yitong" "apellidos" => "Zhang" ] 4 => array:2 [ "nombre" => "Xiaotong" "apellidos" => "Sun" ] 5 => array:2 [ "nombre" => "Xinyuan" "apellidos" => "Gao" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530016424000405?idApp=UINPBA00004N" "url" => "/25300164/0000007100000004/v1_202404080908/S2530016424000405/v1_202404080908/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Metabolic dysfunction-associated steatohepatitis (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) require urgent attention by primary care physicians and endocrinologists" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "149" "paginaFinal" => "151" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Didac Mauricio, Javier Escalada, Antonio Pérez, Manuel Romero-Gómez, Kenneth Cusi, Zobair M. Younoussi, Jeffrey V. Lazarus" "autores" => array:7 [ 0 => array:4 [ "nombre" => "Didac" "apellidos" => "Mauricio" "email" => array:1 [ 0 => "didacmauricio@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Javier" "apellidos" => "Escalada" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 2 => array:3 [ "nombre" => "Antonio" "apellidos" => "Pérez" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] 3 => array:3 [ "nombre" => "Manuel" "apellidos" => "Romero-Gómez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0030" ] ] ] 4 => array:3 [ "nombre" => "Kenneth" "apellidos" => "Cusi" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">g</span>" "identificador" => "aff0035" ] ] ] 5 => array:3 [ "nombre" => "Zobair M." "apellidos" => "Younoussi" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">h</span>" "identificador" => "aff0040" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">i</span>" "identificador" => "aff0045" ] ] ] 6 => array:3 [ "nombre" => "Jeffrey V." "apellidos" => "Lazarus" "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">i</span>" "identificador" => "aff0045" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">j</span>" "identificador" => "aff0050" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">k</span>" "identificador" => "aff0055" ] 3 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">l</span>" "identificador" => "aff0060" ] ] ] ] "afiliaciones" => array:12 [ 0 => array:3 [ "entidad" => "Department of Endocrinology & Nutrition, CIBERDEM – IR Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Faculty of Medicine, University of Vic & Central University of Catalonia, Vic, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Fundación de la Sociedad Española de Endocrinología y Nutrición, Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Sociedad Española de Diabetes, Madrid, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Digestive Diseases Department & CIBEREHD, Virgen del Rocío University Hospital, Institute of Biomedicine of Seville (HUVR/CSIC/US), University of Seville, Seville, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Division of Endocrinology, Diabetes & Metabolism, University of Florida, Gainesville, USA" "etiqueta" => "g" "identificador" => "aff0035" ] 7 => array:3 [ "entidad" => "Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, Virginia, USA" "etiqueta" => "h" "identificador" => "aff0040" ] 8 => array:3 [ "entidad" => "The Global NASH Council, Washington, DC, USA" "etiqueta" => "i" "identificador" => "aff0045" ] 9 => array:3 [ "entidad" => "Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain" "etiqueta" => "j" "identificador" => "aff0050" ] 10 => array:3 [ "entidad" => "Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain" "etiqueta" => "k" "identificador" => "aff0055" ] 11 => array:3 [ "entidad" => "CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA" "etiqueta" => "l" "identificador" => "aff0060" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La esteatohepatitis asociada a disfunción metabólica (MASLD) y la esteatohepatitis asociada a disfunción metabólica (MASH) requieren atención urgente por parte de médicos de atención primaria y endocrinólogos" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In this editorial, we briefly address some of the most relevant issues surrounding metabolic dysfunction-associated steatotic liver disease, including its epidemiology, risk factors, and consequences and the urgent need for increasing awareness about it and early interventions to tackle it.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Non-alcoholic fatty liver disease (NAFLD) and its more aggressive phenotype, non-alcoholic steatohepatitis (NASH), are often overlooked by health systems but demand immediate attention due to their high and increasing prevalence and serious health consequences.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">1</span></a> In recent years, there has been an important debate on the terminology used to describe these conditions, as the names NAFLD and NASH were considered stigmatizing by many, including healthcare professionals.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">2</span></a> Moreover, these terms labelled the diseases for what they were not. In June 2023, global consensus was reached among stakeholders, including healthcare professionals, patient advocates and researchers, to change the nomenclature and definition.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">3</span></a> Steatotic liver disease (SLD) was chosen as the overarching term to encompass the various etiologies of steatosis. The names chosen to replace NAFLD and NASH were metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH), respectively.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Free of the stigmatizing terms ‘alcoholic’ and ‘fatty’, this new terminology labels the diseases for what they are, all while reflecting a growing understanding of the intricate interplay between metabolic factors, such as obesity and type 2 diabetes (T2D), in the development and progression of liver disease. The adoption of MASLD underscores the systemic nature of the condition and its intimate connection to metabolic health. This nomenclature now more accurately reflects the complexity of the disease and highlights the pivotal role of metabolic factors in its pathogenesis. Future research will help to better define the diagnostic value of a single metabolic risk factor (e.g., T2D, obesity, dyslipidemia, hypertension) as a surrogate of insulin resistance and the importance of each of them in the metabolic dysfunction of MASH.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Once considered to be an uncommon disease, MASLD is currently estimated to affect 38% of the global adult population, with this figure nearly doubling among people with T2D.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">5</span></a> The reasons behind this alarming rise are multifaceted and include an increasing prevalence of genetic predispositions, metabolic syndrome (MetS), physical inactivity, and unhealthy dietary habits. MetS, which is characterized by a combination of factors such as abdominal obesity, insulin resistance, high blood pressure, dysglycemia, and dyslipidemia, contributes significantly to the increased burden of obesity and T2D in the context of MASLD.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">1</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">While MASLD might start as a benign accumulation of fat in the liver, it can progress to MASH, which is characterized by inflammation and liver cell damage. MASH can ultimately lead to fibrosis, cirrhosis, and hepatocellular carcinoma. Beyond the liver, MASLD and MASH are also associated with a higher risk of cardiovascular disease, T2D, non-hepatic cancers, sarcopenia, and other metabolic disorders.<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">6,7</span></a> One of the most challenging aspects of MASLD is its largely silent progression. Initially, the condition might not present with any noticeable symptoms, making early detection elusive as individuals are unaware of their status and do not seek medical attention. Many individuals remain unaware of having a hepatic condition until they reach the MASH stage or progress to more advanced liver disease, making early diagnosis crucial.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Given the strong association between MASLD, obesity, and T2D, there is a critical need to involve primary care physicians and endocrinologists in the early detection, prevention, and management of MASLD.<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">8,9</span></a> In most health systems and organizations, these care professionals are on the frontline of managing metabolic conditions and are therefore well-positioned to identify individuals at risk for liver disease. They can thus play a pivotal role in educating patients about the importance of liver health and in advocating and screening for SLD in high-risk populations.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Despite their burden, awareness around MASLD and MASH remains shockingly low among the general public. In one study using the National Health and Nutrition Examination Survey database from the United States, only 4% of subjects who had MASLD were aware of their status.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">10</span></a> Many individuals do not know what MASLD is or how it can affect their health. This lack of knowledge can delay disease diagnosis and treatment, further exacerbating the problem. Healthcare professionals like endocrinologists and primary care physicians are well positioned to help in raising awareness about this serious health issue.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Several actions must be prioritized to properly address the global impact of SLD and all potential stakeholders should be involved.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">11</span></a> For instance, more resources ought to be allocated to increase SLD related translational and clinical research in the field and public health and campaigns to raise awareness about SLD should be launched among at-risk populations. Additionally, the implementation of clinical guidelines in daily practice should be considered a priority by healthcare providers and scientific societies.<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">9,12</span></a> As lifestyle interventions, including improved nutrition and physical activity levels, are the cornerstone of SLD prevention,<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">13</span></a> a holistic approach involving social nutrition and prescribing is pivotal.<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">14</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">SLD reflects a problem driven by social, commercial, and environmental determinants. To combat this public health threat, we must act swiftly, focusing on its prevention, early detection, and effective management that is inclusive of its potential comorbidities. It is time for all stakeholders, including primary care physicians and endocrinologists, to come together to mitigate the serious consequences of this condition on health and health systems.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib0075" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Non-alcoholic fatty liver disease: causes, diagnosis, cardiometabolic consequences, and treatment strategies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "N. Stefan" 1 => "H.U. Häring" 2 => "K. Cusi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S2213-8587(18)30154-2" "Revista" => array:6 [ "tituloSerie" => "Lancet Diabetes Endocrinol" "fecha" => "2019" "volumen" => "7" "paginaInicial" => "313" "paginaFinal" => "324" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30174213" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0080" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Global survey of stigma among physicians and patients with nonalcoholic fatty liver disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Z.M. Younossi" 1 => "S.A. Alqahtani" 2 => "K. Alswat" 3 => "Y. Yilmaz" 4 => "C. Keklikkiran" 5 => "J. Funuyet-Salas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "J Hepatol" "fecha" => "2023" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0085" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A multisociety Delphi consensus statement on new fatty liver disease nomenclature" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.E. Rinella" 1 => "J.V. Lazarus" 2 => "V. Ratziu" 3 => "S.M. Francque" 4 => "A.J. Sanyal" 5 => "F. Kanwal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jhep.2023.06.003" "Revista" => array:6 [ "tituloSerie" => "J Hepatol" "fecha" => "2023" "volumen" => "79" "paginaInicial" => "1542" "paginaFinal" => "1556" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37364790" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0090" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "From NAFLD to MASLD: promise and pitfalls of a new definition" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K. Cusi" 1 => "Z. Younossi" 2 => "M. Roden" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/HEP.0000000000000706" "Revista" => array:2 [ "tituloSerie" => "Hepatology" "fecha" => "2023" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0095" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The burden of nonalcoholic fatty liver disease (NAFLD) is rapidly growing in every region of the world from 1990 to 2019" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.M. Paik" 1 => "L. Henry" 2 => "Y. Younossi" 3 => "J. Ong" 4 => "S. Alqahtani" 5 => "Z.M. Younossi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/HC9.0000000000000251" "Revista" => array:5 [ "tituloSerie" => "Hepatol Commun" "fecha" => "2023" "volumen" => "7" "paginaInicial" => "e0251" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37782469" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0100" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nonalcoholic fatty liver disease (NAFLD) and associated mortality in individuals with type 2 diabetes, pre-diabetes, metabolically unhealthy, and metabolically healthy individuals in the United States" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Golabi" 1 => "J.M. Paik" 2 => "A. Kumar" 3 => "R. Al Shabeeb" 4 => "K.E. Eberly" 5 => "K. Cusi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.metabol.2023.155642" "Revista" => array:5 [ "tituloSerie" => "Metabolism" "fecha" => "2023" "volumen" => "146" "paginaInicial" => "155642" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37380016" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0105" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The global burden of liver disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Z.M. Younossi" 1 => "G. Wong" 2 => "Q.M. Anstee" 3 => "L. Henry" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.cgh.2023.04.015" "Revista" => array:6 [ "tituloSerie" => "Clin Gastroenterol Hepatol" "fecha" => "2023" "volumen" => "21" "paginaInicial" => "1978" "paginaFinal" => "1991" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37121527" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0110" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Identification of high-risk patients with nonalcoholic fatty liver disease in endocrinology clinics" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Z.M. Younossi" 1 => "L. Henry" 2 => "S. Isaacs" 3 => "K. Cusi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eprac.2023.06.012" "Revista" => array:6 [ "tituloSerie" => "Endocr Pract" "fecha" => "2023" "volumen" => "29" "paginaInicial" => "912" "paginaFinal" => "918" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37406857" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0115" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "American Association of Clinical Endocrinology Clinical Practice Guideline for the Diagnosis and Management of Nonalcoholic Fatty Liver Disease in Primary Care and Endocrinology Clinical Settings: co-sponsored by the American Association for the Study of Liver Diseases (AASLD)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Cusi" 1 => "S. Isaacs" 2 => "D. Barb" 3 => "R. Basu" 4 => "S. Caprio" 5 => "W.T. Garvey" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eprac.2022.03.010" "Revista" => array:6 [ "tituloSerie" => "Endocr Pract" "fecha" => "2022" "volumen" => "28" "paginaInicial" => "528" "paginaFinal" => "562" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35569886" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0120" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Poor awareness of liver disease among adults with NAFLD in the United States" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S.A. Alqahtani" 1 => "J.M. Paik" 2 => "R. Biswas" 3 => "T. Arshad" 4 => "L. Henry" 5 => "Z.M. Younossi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/hep4.1765" "Revista" => array:6 [ "tituloSerie" => "Hepatol Commun" "fecha" => "2021" "volumen" => "5" "paginaInicial" => "1833" "paginaFinal" => "1847" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34558829" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0125" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A global action agenda for turning the tide on fatty liver disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.V. Lazarus" 1 => "H.E. Mark" 2 => "A.M. Allen" 3 => "J.P. Arab" 4 => "P. Carrieri" 5 => "M. Noureddin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/HEP.0000000000000545" "Revista" => array:2 [ "tituloSerie" => "Hepatology" "fecha" => "2023" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0130" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Consensus document. Management of non-alcoholic fatty liver disease (NAFLD). Clinical practice guideline" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Aller" 1 => "C. Fernández-Rodríguez" 2 => "O. Lo Iacono" 3 => "R. Bañares" 4 => "J. Abad" 5 => "J.A. Carrión" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Gastroenterol Hepatol" "fecha" => "2018" "volumen" => "41" "paginaInicial" => "328" "paginaFinal" => "349" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0135" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lifestyle interventions in nonalcoholic fatty liver disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Z.M. Younossi" 1 => "S. Zelber-Sagi" 2 => "L. Henry" 3 => "L.H. Gerber" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/s41575-023-00800-4" "Revista" => array:6 [ "tituloSerie" => "Nat Rev Gastroenterol Hepatol" "fecha" => "2023" "volumen" => "20" "paginaInicial" => "708" "paginaFinal" => "722" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37402873" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0140" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Integrating social nutrition principles into the treatment of steatotic liver disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Ivancovsky-Wajcman" 1 => "P.N. Brennan" 2 => "C.J. Kopka" 3 => "S. Zelber-Sagi" 4 => "Z.M. Younossi" 5 => "A.M. Allen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/s43856-023-00398-3" "Revista" => array:5 [ "tituloSerie" => "Commun Med (Lond)" "fecha" => "2023" "volumen" => "3" "paginaInicial" => "165" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37950056" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack738091" "titulo" => "Acknowledgements" "texto" => "<p id="par0050" class="elsevierStylePara elsevierViewall">JVL acknowledges support to ISGlobal from grant <span class="elsevierStyleGrantNumber" refid="gs1">CEX2018-000806-S</span>, funded by <span class="elsevierStyleGrantSponsor" id="gs1">MCIN/AEI/10.13039/501100011033</span>, and the <span class="elsevierStyleGrantSponsor" id="gs2">‘Generalitat de Catalunya’</span>, through the CERCA Programme, outside of the submitted work.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/25300164/0000007100000004/v1_202404080908/S2530016424000259/v1_202404080908/en/main.assets" "Apartado" => array:4 [ "identificador" => "63842" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Editorial" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/25300164/0000007100000004/v1_202404080908/S2530016424000259/v1_202404080908/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530016424000259?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 10 | 2 | 12 |
| 2024 October | 41 | 20 | 61 |
| 2024 September | 17 | 13 | 30 |
| 2024 August | 1 | 2 | 3 |
| 2024 July | 1 | 0 | 1 |
| 2024 June | 5 | 1 | 6 |
| 2024 May | 2 | 0 | 2 |
| 2024 April | 14 | 10 | 24 |
| 2024 March | 5 | 3 | 8 |
| 2024 February | 3 | 0 | 3 |
